Road operation phase sustainability indicator as a response to the climate change phenomena

Road infrastructure is a major contributor of greenhouse gas (GHG) around the world. Once constructed, a road becomes a part of a road network and is subjected to recurrent maintenance/rehabilitation activities. Studies to date are mostly aimed at the development of sustainability indicators that deal with the material and construction phases of a road when it is constructed. The operation phase is infrequently studied and there is a need for sustainability indicators to be developed relating to this phase to better understand the GHG emissions as a proper response to the climate change phenomena. During the operation phase, maintenance/rehabilitation activities are undertaken based on certain agreed intervention criteria that do not include environmental implications relating to the climate change aspect properly. Availability of appropriate indicators may, therefore, assist in sustainable road asset maintenance management. This paper presents the findings of a literature based study and has proposed a way forward to develop a key “road operation phase” environmental indicator, which can contribute to road operation phase carbon footprint management based on a comprehensive road life cycle system boundary model. The proposed indicator can address multiple aspects of high impact road operation life environmental components such as: pavement rolling resistance, albedo, material, traffic congestion and lighting, based on availability of relevant scientific knowledge. Development of the indicator to appropriate level would offset the impacts of these components significantly and contribute to sustainable road operation management

Comparison of outcome between suture and suture-less surgery following pterygium excision and conjunctival autograft

Background: A pterygium, known as surfer's eye, is a raised, wedge-shaped growth of the conjunctiva that extends onto the cornea, the outer layer of the eye. Aim was to compare the safety, efficacy and outcome of suture less technique with suture of conjunctival autograft in the management of pterygium. Methods: This study was carried out in the department of ophthalmology, Sir Salimullah medical college and Mitford hospital, Dhaka. Study period was July 2019 to June 2020. Subjects for this study were divided into two groups, forty patients were enrolled in each group of the study population. Group I (control) comprised the subjects in whom suture was used following pterygium excision and conjunctival autograft and group II (experimental) comprised the subjects in whom no suture was used following pterygium excision and conjunctival autograft. Results: In group I, 20% were 20-29 years old, 30% were 30-39, 27.5% were 40-49, and 22.5% were over 50, with 77.5% being male and 22.5% female. In group II, 22.5% were 20-29 years old, 27.5% were 30-39, 30% were 40-49, and 20% were over 50, with 72.5% being male and 27.5% female. The most common symptom was "foreign body sensation" in both groups. In group I, 5% experienced partial graft dehiscence, 2.5% a conjunctival cyst, 10% hyperemia, and 17.5% visual improvement. In group II, 2.5% had partial graft dehiscence, 2.5% hyperemia, and 22.5% visual improvement. Neither group had graft retraction or recurrence. Conclusions: Postoperative presentation like hyperemia was significantly less in experimental group. Incidence of post-operative complications like graft dehiscence and conjunctival cyst were comparatively less frequent in suture less technique. Thus, suture less technique following pterygium excision and conjunctival autograft is a safer and less complicated than sutured technique

Water quality and unseen health outcomes: a cross-sectional study on arsenic contamination, subclinical disease and psychosocial distress in Bangladesh

Health risks from water quality pose a major threat to billions of people globally. Most microbial contaminants have short subclinical periods, compared to chemical contaminants that can take years to manifest, which can translate to less attention in the policy sphere. Complex water quality issues in Bangladesh, including arsenic contamination, offer an ideal case study to highlight the wide-ranging health and social impacts of perceived and invisible contaminants. This paper presents a cross-sectional study where two tools are explored for understanding the less visible health impacts of water contamination: (1) measuring subclinical disease via nail arsenic measurements (n = 899) to better ascertain chronic exposure; and (2) understanding the relationship between water quality and psychosocial distress (n = 876), for men and women across three sites with varying water quality issues. Applying generalised linear regression models, subclinical arsenic showed strong positive correlation with water arsenic, while the relationship between severity of psychosocial distress and water arsenic was modified by perceived risk from arsenic. Subclinical disease was much more prevalent than what current exposure through drinking water would indicate, with 65.3% of participants having nail arsenic levels above the 1 μg/g cut-off for unexposed individuals (spanning across sites with average water arsenic as low as 2.51 μg/L and as high as 379 μg/L). Further demonstrating the breadth of unseen outcomes of water contamination, uncertainty was the most commonly expressed component of distress, followed by worry, fear, suffering, and lack of choice. The presence of psychosocial distress underscores how experiences of contaminated water go beyond physiological illnesses, while the use of subclinical biomarkers can shift the understanding of disease and provide a useful way of leveraging policy change by pinpointing exactly where and by whom intervention is needed

PREBIOTIC EFFECT OF DAILY FRUCTOOLIGOSACCHARIDE INTAKE ON WEIGHT GAIN AND REDUCTION OF ACUTE DIARRHEA AMONG CHILDREN IN A BANGLADESH URBAN SLUM: A Randomized Double-masked Placebo-controlled Study

Fructooligosaccharide (FOS) is a typical prebiotic agent. A randomized, double-masked, placebo-controlled study was performed to evaluate the prebiotic effect of daily intake of an isotonic solution containing FOS on body weight gain and the reduction of diarrhea in children in an urban slum in Bangladesh over six consecutive months. We enrolled a total of 150 children, aged 25-59 months. Sixty-four children in the FOS group received 50 mL of isotonic solution with 2 g of FOS added, and 69 children in the placebo group were given an identical solution with 1 g of glucose added, once a day. The measurement of body weight was carried out every other day; height and arm circumference were measured once a month; and the children‘s mothers were interviewed to obtain data about diarrhea, the consistency and constitution of stool, other symptoms, and antibiotic treatment. As a result, the body weight gain during the six-month period was 0.86±0.55 kg in the FOS group and 0.89±0.48 kg in the placebo group, while the increase in height and arm circumference were not significantly different between the two groups. The number of diarrhea episodes during the six-month period was not significantly different. A significant reduction in the duration of diarrhea days and of duration per episode was observed in the FOS group (p=0.039 and p=0.008, respectively). In conclusion, daily intake of FOS was associated neither with the children‘s growth nor with the number of diarrhea episodes, but a significant reduction in the duration of diarrhea days was observed. Further studies are needed to confirm the effects of FOS by changing the doses and eliminating the influence of antibiotics

Cryptic Anuran Biodiversity in Bangladesh Revealed by Mitochondrial 16S rRNA Gene Sequences

To survey the diversity of anuran species in Bangladesh, we compared mitochondrial 16S rRNA gene sequences (approximately 1.4 kbp) from 107 Bangladesh frog specimens. The results of genetic divergence and phylogenetic analyses incorporating data from related species revealed the occurrence of at least eight cryptic species. Hoplobatrachus tigerinus from two districts diverged considerably, indicating the involvement of a cryptic species. Two Fejervarya sp. (large and medium types) and Hylarana cf. taipehensis formed lineages distinct from related species and are probably new species. Microhyla cf. ornata differed from M. ornata with respect to type locality area and involved two distinct species. In addition, we found that Hylarana sp. and Microhyla sp. did not match congeners examined to date in either morphology or 16S rRNA sequence. The occurrence of M. fissipes was tentatively suggested. Consequently, at least, 19 species were found from Bangladesh in this study. These findings revealed a rich anuran biodiversity in Bangladesh, which is unexpected considering the rather simple topographic features of the country.This work was supported by Grants-in-Aid for Scientific Research (C) (Nos. 17570082 and 20510216) to M. Sumida from the Ministry of Education, Culture, Sports, Science and Technology, Japan

Risk factors and in-hospital outcome of acute ST segment elevation myocardial infarction in young Bangladeshi adults

BackgroundSouth Asians have a higher overall incidence rate and younger age of onset for acute myocardial infarction (AMI) compared to Western populations. However, limited information is available on the association of preventable risk factors and outcomes of AMI among young individuals in Bangladesh. The aim of this study was to determine the risk factors and in-hospital outcome of AMI among young (age &le;40 years) adults in Bangladesh.MethodsWe conducted a prospective observational study among consecutive 50 patients aged &le;40 years and 50 patients aged &gt;40 years with acute ST Segment Elevation Myocardial Infarction (STEMI) and followed-up in-hospital at the National Institute of Cardiovascular Diseases (NICVD). Clinical characteristics, biochemical findings, diet, echocardiography and in-hospital outcomes were compared between the two groups. Multivariate logistic regression was performed to assess the association between risk factors and in-hospital outcome in young patients adjusting for other confounding variables.ResultsThe mean age of the young and older patient groups was 36.5&thinsp;&plusmn;&thinsp;4.6 years and 57.0&thinsp;&plusmn;&thinsp;9.1 years respectively. Male sex (OR 3.4, 95 % CI 1.2&thinsp;&minus;&thinsp;9.75), smoking (OR 2.4, 95 % CI 1.04&thinsp;&minus;&thinsp;5,62), family history of MI (OR 2.4, 95 % CI 1.11&thinsp;&minus;&thinsp;5,54), homocysteine (OR 1.2, 95 % CI 1.08&thinsp;&minus;&thinsp;1.36), eating rice &ge;2 times daily (OR 3.5, 95 % CI 1.15&thinsp;&minus;&thinsp;10.6) and eating beef (OR 4.5, 95 % CI 1.83&thinsp;&minus;&thinsp;11.3) were significantly associated with the risk of AMI in the young group compared to older group. In multivariate analysis, older patients had significantly greater chance of developing heart failure (OR 7.5, 95 % CI 1.51 to 37.31), re-infarction (OR 7.0, 95 % CI 1.08&thinsp;&minus;&thinsp;45.72), arrhythmia (OR 15.3, 95 % CI 2.69&thinsp;&minus;&thinsp;87.77) and cardiogenic shock (OR 69.0, 95 % CI 5.81&thinsp;&minus;&thinsp;85.52) than the younger group.ConclusionYounger AMI patients have a different risk profile and better in-hospital outcomes compared to the older patients. Control of preventable risk factors such as smoking, unhealthy diet, obesity and dyslipidemia should be reinforced at an early age in Bangladesh.<br /

Every Newborn-Reach Up Early Education Intervention for All Children (EN-REACH)- a parent group intervention for school readiness in Bangladesh, Nepal, and Tanzania: study protocol for a cluster randomized controlled trial.

BACKGROUND: Vulnerable children, including those with neuro-developmental delays and disabilities, often face barriers in accessing early primary education, thus hindering progress toward Sustainable Development Goal 4.2. Evidence-based interventions are essential to enhancing inclusivity and establishing sustainable implementation strategies to address this challenge. This study, Every Newborn-Reach up Early Education Intervention for All Children (EN-REACH), builds on the previous Every Newborn- Simplified Measurement Integrating Longitudinal Neurodevelopmental and Growth (EN-SMILING) observational cohort study. This paper provides the protocol for a cluster randomized controlled trial (cRCT) to evaluate the effectiveness of a parenting group intervention program for enhancing school readiness in Bangladesh, Nepal, and Tanzania, and an embedded process evaluation to inform scalability and feasibility. METHODS: EN-REACH is a cRCT with at least 150 clusters to evaluate the impact of a parent training program led by trained parent-teacher facilitator pairs, focusing on children aged 4 ~ 6 years preparing for preschool. Approximately 500 participants from the EN-SMILING cohort at each site have been identified. A geographic information system will define ~ 50 clusters in each of the three countries, each with approximately ten parent-child dyads. Half the clusters will be randomly assigned to intervention and control groups. The primary outcome is "school readiness", assessed using the Measuring Early Learning Quality and Outcomes tool. Secondary outcomes include Intelligence Quotient, child functioning, growth, visual, and hearing assessments. Data will be collected at baseline, and post-intervention data following implementation of the parent group intervention sessions over approximately 5 months. Quantitative data on coverage and quality care, combined with qualitative insights from children, caregivers, facilitators, and stakeholders' perspectives, will be used to conduct a process evaluation applying the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework.  DISCUSSION: This protocol details a trial focused on enhancing school readiness and cognitive abilities in young children, inclusive of those with disabilities, aiming to bridge gap from home to early primary education. EN-REACH aims to provide insights into the effectiveness and acceptability of a co-designed disability-inclusive school readiness program in three countries, potentially impacting national and global policies for all children, including those with disabilities. TRIAL REGISTRATION: The trial was retrospectively registered on clinicaltrials.gov on 29 February 2024 (NCT06334627)

Environmental indicators for sustainable road development and operation

Road construction, maintenance and operation are activities that impact the environment by way of energy use, resource consumption and emission. Components such as construction material, transportation, street lighting, rolling resistance, traffic congestion during works, albedo and end-of-life processing impact the environment at different phases of the life of a road. With a view to promote sustainable development, a few sustainability rating schemes, e.g. Infrastructure Sustainability and Invest (Australia), Envision and Greenroads (USA), and CEEQUAL (UK) have been developed, that can assess road projects. These schemes address environmental areas such as: energy and emission, land, water, materials, discharges into surroundings, waste and ecology as factors for sustainable development. This paper assesses different rating schemes based on a defined comprehensive life cycle assessment (LCA) system boundary for road projects to identify different environmental indicators that address sustainable road development and operation. The findings indicate that new indicators are required to address different environmental components during the operation phase of roads

Sustainability outcomes of infrastructure sustainability rating schemes for road projects

The construction and operation of infrastructure assets can have significant impact on society and the region. Using a sustainability assessment framework can be an effective means to build sustainability aspects into the design, construction and operation of infrastructure assets. The conventional evaluation processes and procedures for infrastructure projects do not necessarily measure the qualitative/quantitative effectiveness of all aspects of sustainability: environment, social wellbeing and economy. As a result, a few infrastructure sustainability rating schemes have been developed with a view to assess the level of sustainability attained in the infrastructure projects. These include: Infrastructure Sustainability (Australia); CEEQUAL (UK); and Envision (USA). In addition, road sector specific sustainability rating schemes such as Greenroads (USA) and Invest (Australia) have also been developed. These schemes address several aspects of sustainability with varying emphasis (weightings) on areas such as: use of resources; emission, pollution and waste; ecology; people and place; management and governance; and innovation. The attainment of sustainability of an infrastructure project depends largely on addressing the whole-of-life environmental issues. This study has analysed the rating schemes’ coverage of different environmental components for the road infrastructure under the five phases of a project: material, construction, use, maintenance and end-of-life. This is based on a comprehensive life cycle assessment (LCA) system boundary. The findings indicate that there is a need for the schemes to consider key (high impact) life cycle environmental components such as traffic congestion during construction, rolling resistance due to surface roughness and structural stiffness of the pavement, albedo, lighting, and end-of-life management (recycling) to deliver sustainable road projects

Life cycle analysis for sustainability assessment of road projects

Road infrastructure has been considered as one of the most expensive and extensive infrastructure assets of the built environment globally. This asset also impacts the natural environment significantly during different phases of life e.g. construction, use, maintenance and end-of-life. The growing emphasis for sustainable development to meet the needs of future generations requires mitigation of the environmental impacts of road infrastructure during all phases of life e.g. construction, operation and end-of-life disposal (as required). Life-cycle analysis (LCA), a method of quantification of all stages of life, has recently been studied to explore all the environmental components of road projects due to limitations of generic environmental assessments. The LCA ensures collection and assessment of the inputs and outputs relating to any potential environmental factor of any system throughout its life. However, absence of a defined system boundary covering all potential environmental components restricts the findings of the current LCA studies. A review of the relevant published LCA studies has identified that environmental components such as rolling resistance of pavement, effect of solar radiation on pavement(albedo), traffic congestion during construction, and roadway lighting &amp; signals are not considered by most of the studies. These components have potentially higher weightings for environment damage than several commonly considered components such as materials, transportation and equipment. This paper presents the findings of literature review, and suggests a system boundary model for LCA study of road infrastructure projects covering potential environmental components